Evidence based practice

Question 1

What are the pros of EBC (evidence based care)

Answer 1

looks for the very best scientific and clinical evidence for treating and managing a problem

improves quality, safely and patient outcomes

increases nurse satisfaction

reduces costs

Question 2

where does the best evidence come from?

TEST Q

Answer 2

• well designed
• systematically conducted research studies
• in scientific/ peer reviewed journals

Question 3

the need for evidence based practice “bedside” implications

what all adds to “evidence-based clinical decision making” ?

Answer 3

• evidence from research, evidence based theories, clinical experts, and opinion leaders
• evidence from assessment of patients history and physical and available health care resources
• information about patient preferences and values
• clinical expertise

Question 4

sources of evidence?

Answer 4

• textbooks
• articles from nursing and health care literature
• peer reviewed journals

Question 5

application of evidence

Answer 5

differ based on patients values, state of health, preferences, concerns or expectations

involves ethical and accountable professional nursing practice

use critical thinking skills

Question 6

what the steps of evidence based practice?

Answer 6

Cultivate - a spirit of inquiry

Ask- a clinical question in PICOT format

Search - for the best evidence

Appraise- critically appraise the evidence

Integrate - the evidence

evaluate- the outcomes of practice decision or changes

communicate/share- the outcomes of the evidence based practice decision.

Question 7

Cultivate a spirit of inquiry

what are the parts ?

Answer 7

• must have never ending spirit of inquiry

constantly questioning current practices

cultivate/ work at an institution where nurses are encouraged to question practices

Question 8

Ask a clinical question in the PICOT format ?

Answer 8

developing a PICOT question

P-patient population of interest 
I- intervention of interest 
C- comparison of interest 
O- Outcome 
T-time 

Example: will patients with diabetes (P) who take Lantus (I) at bedtime have better A1 C levels (O) after 6 months (T) than those who take Lantus in the morning (C)

Question 9

search for the best evidence

Answer 9

ASK experts for help

• nursing faculty
• Librarians
• advanced practice nurses
• staff educators/ developers
• risk managers

A medical librarian can

• identify the databases that are available to you
• identify key words that will provide the best answer to your PICOT question.

Question 10

Critically appraise the evidence

Answer 10

after critiquing all articles for a PICOT question

• synthesize or combine the findings
• consider the scientific rigor/quality of evidence and whether it has application in practice

requires systematic approach to determine

• value
• feasibility
• usefulness of evidence

Question 11

Integrate the evidence

Answer 11

-pilot study can show if change can be implemented easily. ALWAYS consider a pilot study…learning on a small scale can forestall challenges

-apply the research in your plan of care for a patient
use evidence as rationale
just like on your CRT!!
-incorporate into policies and procedures
-education about the change must occur
-large-scale change requires planning.

Question 12

Evaluate the outcomes of the Practice Decision or change

Answer 12

after applying evidence, evaluate the outcome

• was the change effective?
• are modifications needed?
• should the change be discontinued

unexpected events or results may occur

Question 13

communicate the outcomes of the evidence-based practice decision

Answer 13

after implementing, communicate the results

• clinical staff on the unit
• nursing practice council or the research council
• clinicians outside of unit/facility
• professional conferences and meetings

Question 14

Nursing research

Answer 14

A way to identify new knowledge, improve professional education and practice, and use resources effectively

many professional and specialty nursing organizations support the conduct of research for advancing nursing science.

Question 15

Outcomes Research

Answer 15

• helps patients/providers make informed decisions on the basis of current evidence
• typically focuses on the benefits, risk, costs and holistic effects of a treatment on patients
• outcomes must be observable or measurable

Question 16

Scientific method

Answer 16

• is THE foundation of research
• the most reliable and objective means of acquiring and conducting research and gaining knowledge
• a step- by- step process to ensure that findings from a study are valid, reliable, and generalizable to a similar group of subjects.

Question 17

which of the following is the first step of the research process

Answer 17

IDENTIFY the problem

Question 18

Nursing and the scientific approach

Answer 18

-research allows you to study nursing questions and problems in greater depth within the context of nursing.

Quantitative

• experimental research
• nonexperimental research
• surveys
• evaluation research

Qualitative

• ethnography
• phenomenology
• grounded theory

Question 19

Research Process

Answer 19

• identify area of inquiry
• literature review
• form research team
• design study
• obtain approval from participants (informed consent)
• collect data, considering data limitations
• address implications for nursing practice

Question 20

Performance improvement (PI)

Answer 20

• it is a formal approach for the analysis of health care-related processes

Outcomes measures
-begins at staff level in identifying quality problems

sentinel events: a patients safety event that results in death, permanent harm or severe temporary harm

active errors: made by people on the from line such as clinicians and nurses

latent errors: less apparent failures of organization or design that contribute to the occurrence of active errors

PI +EBP= excellent patient care and outcomes.